反向斜坡试验在左心室辅助装置支持和心肌恢复中的应用。

Reverse Ramp Testing in Left Ventricular Assist Device Support and Myocardial Recovery.

机构信息

From the Department of Medicine, Division of Cardiology, University of Chicago, Chicago, Illinois.

出版信息

ASAIO J. 2020 Jan;66(1):e1-e4. doi: 10.1097/MAT.0000000000001010.

PMID:31192841

Abstract

Mechanical unloading with left ventricular assist device (LVAD) support can lead to clinically meaningful reversal of stress-related compensatory mechanisms. However, true assessment of left ventricular ejection fraction (LVEF) is not possible, whereas the left ventricle is unloaded by LVAD therapy making identification of patients with myocardial recovery even more challenging. We introduce our new protocol, the "reverse ramp test" for HeartWare HVAD, HeartMate II, and HeartMate 3. The reverse ramp is transthoracic echo (TTE) and right heart catheterization (RHC)-based protocol with LVAD turn down steps to minimal support allowing for a more accurate assessment of myocardial function.

摘要

机械卸载与左心室辅助装置（LVAD）支持可导致与压力相关的代偿机制的临床意义上的逆转。然而，真正的左心室射血分数（LVEF）评估是不可能的，而左心室通过 LVAD 治疗卸载，使得识别心肌恢复的患者更加具有挑战性。我们引入了我们的新方案，即 HeartWare HVAD、HeartMate II 和 HeartMate 3 的“反向斜坡试验”。反向斜坡是基于经胸超声心动图（TTE）和右心导管术（RHC）的方案，LVAD 逐步降低至最低支持，以更准确地评估心肌功能。